Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences最新文献

{"title":"Feigan granules improve traditional Chinese medicine symptoms scale scores for influenza patients: a prospective clinical observational Study.","authors":"Weihao Chen, Dongsheng Zheng, Shuangshuang DU, Qian Li, Guolin Wu, Dongsheng Hong, Qingwei Zhao","doi":"10.3724/zdxbyxb-2024-0559","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0559","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical efficacy of hospital-prepared Chinese medicine Feigan granules for influenza patients.</p><p><strong>Methods: </strong>A prospective observational study was conducted on influenza patients who visited the Fever Clinic of the First Affiliated Hospital, Zhejiang University School of Medicine between February 2024 and March 2024 were enrolled. Patients were divided into an observation group (Feigan granules combined with conventional Western medicine) and a control group (conventional Western medicine) based on whether they used Feigan granules. Main symptoms (including fever, cough and sore throat) and secondary symptoms (including chest tightness, poor appetite, muscle soreness and dry mouth) were evaluated with traditional Chinese medicine (TCM) symptom scale on the first day of the patient's visit and the third day after treatment. The degrees of improvement in the TCM symptom scores before and after treatment were compared using the paired rank-sum test, and the differences in the overall symptom efficacy index between two groups were compared using the Wilcoxon test.</p><p><strong>Results: </strong>A total of 217 influenza patients were included. After treatment, the TCM symptom scores of both groups were significantly improved compared with those before treatment (all <i>P</i><0.05). The median difference in the main symptom score before and after treatment in the study and the control groups was 7 points (95%<i>CI</i>: 6.0-8.0) and 6 points (95%<i>CI</i>: 6.0-8.0), respectively; the median difference in the secondary symptom score was 3 points (95%<i>CI</i>: 2.0-4.0) in both groups. The median difference in the total score was 9 points (95%<i>CI</i>: 8.0-10.5) and 8 points (95%<i>CI</i>: 7.0-10.0) in the study and control groups, respectively. In the subgroup with an initial cough score >2, the improvement rates of overall symptoms (97.06% <i>vs</i>. 92.59%) and secondary symptoms (92.31% <i>vs</i>. 85.11%) in study group were significantly higher than those in the control group (<i>P</i><0.05); while there was no significant difference in the improvement rate of main symptoms (95.59% <i>vs</i>. 90.74%, <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>Feigan granules can improve the TCM syndromes of influenza patients, especially for patients with more severe cough.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Scleromitrion diffusum</i> reverses epithelial mesenchymal trans-formation of gastric mucosa in rats with gastricprecancerous lesions.","authors":"Luping Ma, Xin Zuo, Weikai Zhu, Jiyan Li, Yanyan Zhao, Jingyuan Zhang, Hui Shen","doi":"10.3724/zdxbyxb-2024-0536","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0536","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of <i>Scleromitrion diffusum</i> on gastric mucosal epithelial mesenchymal transformation (EMT) in rats with gastric precancerous lesion.</p><p><strong>Methods: </strong>50 SD rats were randomly divided into blank control group (<i>n</i>=11), model control group (<i>n</i>=13), <i>Scleromitrion diffusum</i> (SD) group (<i>n</i>=13) and vitase group (<i>n</i>=13). Gastric precancerous lesion animal model was prepared by 1-methyl-3-nitro-1-nitroso guanidine complex polyfactor method, and the drugs were administrated by gavage after successful modeling once a day for 6 weeks. The pathological changes of gastric mucosa were observed with hematoxylin-eosin staining, the expression of EMT marker proteins were detected with immunohistochemical staining and Western blotting.</p><p><strong>Results: </strong>Compared with the model control group, the gastric mucosal injury was significantly attenuated in the SD group, the mucosal tissue structure gradually recovered, the saccular expansion area was reduced, and the inflammatory infiltration was ameliorated. The expression level of epithelial cadherin was higher, and the expression levels of neural cadherin and vimentin were lower than those of model control group (all <i>P</i><0.05).</p><p><strong>Conclusions: </strong><i>Scleromitrion diffusum</i> can ameliorate gastric mucosal injury in rats with gastric precancerous lesion by reversing epithelial mesenchymal transformation.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on glycolipid metabolism of Sertoli cell in the development of spermatogenic cell].","authors":"Shuhao Li, Liang Kong, Jingyan Liang, Tan Ma","doi":"10.3724/zdxbyxb-2024-0346","DOIUrl":"10.3724/zdxbyxb-2024-0346","url":null,"abstract":"<p><p>Sertoli cells play an important role in the process of spermatogenesis, and the abnormalities in spermatogenesis are closely related to disruptions in glycolipid metabolism. The metabolic environment of Sertoli cells is hypoxic, with glycolysis and fatty acid β-oxidation being the primary metabolic pathways. In Sertoli cells, glycolysis produces lactate to provide energy for spermatogenic cells, while fatty acid β-oxidation generates ATP. Currently, the relationship between glycolipid metabolism in Sertoli cells and spermatogenic cell development, as well as the interplay between glucose and lipid metabolism remain unclear. Various hormones, including sex hormones, can affect glucose metabolism in Sertoli cells by endocrine regulation. The activation or inhibition of signaling pathways such as AMPK, mTOR, and Akt can alter the expression levels of glycolysis-related transporter genes and the synthesis of fatty acids, thereby affecting glycolipid metabolism in Sertoli cells. Some transcription factors such as PPARγ can regulate downstream fatty acid metabolism-related genes by directly binding to their response elements and promoting the oxidation of fatty acids in Sertoli cells. In this article we elaborate on the key factors influencing glycolipid metabolism in Sertoli cells and their interconnections, as well as their potential clinical implications, offering new insights for precisely targeted treatments of male infertility.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"257-265"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Structural valve deterioration after transcatheter aortic valve replacement: a research update].","authors":"Mengyun Yan, Zhengang Zhao, Mao Chen","doi":"10.3724/zdxbyxb-2024-0470","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0470","url":null,"abstract":"<p><p>Structural valve deterioration (SVD) refers to intrinsic and irreversible pathological changes in the components of prosthetic heart valves, manifesting as fibrosis, calcification, wear and tear, loosening, as well as strut fracture or deformation of the valve framework. These changes ultimately lead to valve stenosis and/or regurgitation.The mechanisms may be related to mechanical stress, immune response and abnormal calcium-phosphorus metabolism. Studies have shown that risk factors for SVD include patient factors (such as age, underlying cardiovascular disease and comorbidities), valve factors (such as material properties, processing techniques, and valve type), and surgical factors (such as valve injury, suboptimal stent expansion, and irregular stent release morphology). Clinical imaging assessment of SVD demonstrates complementary advantages among echocardiography, multi-detector spiral CT and cardiac magnetic resonance imaging, with distinct diagnostic objectives. The primary management strategies for SVD after trans-catheter aortic valve replacement (TAVR) include drug therapy, redo-TAVR, surgical aortic valve replacement (SAVR) and the novel SURPLUS technique. Among them, redo-TAVR has become a common method because of its minimally invasive nature, but it is still necessary to further clarify the patient indications and optimize the surgical strategy. SAVR is reserved for young, low-risk patients; SURPLUS combines the advantages of SAVR and TAVR, making it suitable for cases where redo-TAVR is unfeasible or contraindicated, while the risk of SAVR is excessively high. This article reviews the latest progress of SVD following TAVR treatment to provide reference for research into the durability of bioprosthetic valve and clinical intervention of SVD.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":"54 2","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Single-center experience in the treatment of severe aortic stenosis with Xcor^TM transcatheter aortic valve replacement system: 1-year follow-up results].","authors":"Shengwen Wang, Haozhong Liu, Haijiang Guo, Tong Tan, Hanxiang Xie, Xiang Liu, Hailong Qiu, Jimei Chen, Huiming Guo, Jian Liu","doi":"10.3724/zdxbyxb-2024-0487","DOIUrl":"10.3724/zdxbyxb-2024-0487","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the early clinical outcomes of the Xcor^TM transcatheter aortic valve replacement (TAVR) system in treating severe aortic stenosis. This study has been registered at Chinese Clinical Trial Registry (ChiCTR2200065593).</p><p><strong>Methods: </strong>This single-arm, prospective clinical trial enrolled patients with severe aortic stenosis treated with the Xcor^TM TAVR system at the Section of Heart Valve & Coronary Artery Surgery, Guangdong Provincial People's Hospital. Perioperative and follow-up parameters were compared to evaluate differences in hemodynamic outcomes. All-cause mortality, aortic regurgitation, paravalvular leakage, cerebrovascular events, and reoperation were analyzed.</p><p><strong>Results: </strong>Thirty-two patients with severe aortic stenosis were included (20 males, 12 females), with (70.9±4.3) years old and a Society of Thoracic Surgeons (STS) score of 6.45% (6.07%, 7.28%). Notably, 87.5% of patients had New York Heart Association (NYHA) class≥Ⅲ. All patients underwent successful Xcor^TM bioprosthesis implantation, achieving an immediate technical success rate of 100.0% and device success rate of 96.9%. Mean aortic valve gradient decreased from (55.21±23.17) mmHg (1 mmHg=0.133 kPa) to (8.45±5.30) mmHg, peak aortic jet velocity decreased from (4.66±0.85) m/s to (1.99±0.48) m/s, aortic valve area increased from (0.66±0.21) cm² to (2.09±0.67) cm² (all <i>P</i><0.01). Intraoperative ventricular fibrillation occurred in one patient, while one case exhibited moderate prosthetic valve regurgitation and paravalvular leakage post-procedure. At 12-month follow-up, sustained improvements were observed in cardiac function, left ventricular ejection fraction, hemodynamic parameters, and SF-12 quality-of-life scores (all <i>P</i><0.01). All-cause mortality was 12.5% (4/32), with 13.8% (4/29) developing moderate paravalvular leakage.</p><p><strong>Conclusions: </strong>The Xcor^TM TAVR system demonstrated favorable early outcomes in severe aortic stenosis patients, significantly improving symptoms and hemodynamics while exhibiting excellent performance in preventing malignant arrhythmias and coronary obstruction.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"141-148"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of coronary artery protection in transcatheter aortic valve replacement of quadricuspid aortic valve].","authors":"Zhipeng Chen, Dong Yang, Han Zhang","doi":"10.3724/zdxbyxb-2024-0411","DOIUrl":"10.3724/zdxbyxb-2024-0411","url":null,"abstract":"<p><p>A 72-year-old patient with quadricuspid aortic valve underwent transcatheter aortic valve replacement due to severe valve stenosis accompanied by moderate insufficiency. As initially planned, the right coronary artery was protected during the procedure. However, after the artificial valve was released, the left coronary artery was found to be blocked, so a coronary protection stent was implanted in the left coronary artery ostium under the guidance of intravascular ultrasonography. This case indicates that for patients with a quadricuspid aortic valve undergoing transcatheter aortic valve replacement, in addition to preoperative measurement of the aortic root, attention should also be paid to the coronary artery obstruction caused by the displacement of the artificial valve frame during the procedure.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"161-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The association between biological aging markers and valvular heart diseases].","authors":"Xiangjing Liu, Da Luo, Zheng Hu, Hangyu Tian, Hong Jiang, Jing Chen","doi":"10.3724/zdxbyxb-2024-0416","DOIUrl":"10.3724/zdxbyxb-2024-0416","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the association between biological aging markers (phenotypic age and phenotypic age acceleration) and valvular heart diseases.</p><p><strong>Methods: </strong>Research subjects who met the inclusion and exclusion criteria were selected from the UK Biobank from 2006 to 2010. The phenotypic age and phenotypic age acceleration were calculated. Cox multivariate analysis was used to examine the relationship between the aging markers and valvular heart diseases. Sensitivity analysis was conducted by removing missing values and subgroup analysis. The predictive accuracy of phenotypic age and phenotypic age acceleration for valvular heart diseases was analyzed using receiver operating characteristic (ROC) curves, and a clinical decision curve was generated based on logistic regression.</p><p><strong>Results: </strong>A total of 411 687 subjects were included in the study, among whom there were 14 258 patients with valvular heart diseases. The overall median follow-up time was 12.80 years, the median follow-up time for patients with non-rheumatic aortic valve diseases (<i>n</i>=5238), non-rheumatic mitral valve diseases (<i>n</i>=4558), and non-rheumatic tricuspid valve diseases (<i>n</i>=411) were 12.82 years, 12.83 years and 12.84 years, respectively. After adjusting for demographic factors (gender, race, education, Townsend deprivation index), anthropometric factors (body mass index), lifestyle factors (smoking, alcohol consumption, Dietary Approaches to Stop Hypertension score), hypertension and hyperlipidemia, Cox multivariate analysis showed phenotypic age and phenotypic age acceleration were independent risk factors for valvular heart diseases, including non-rheumatic aortic valve diseases, non-rheumatic mitral valve diseases, and non-rheumatic tricuspid valve diseases (phenotypic age: corrected <i>HR</i>=1.04, <i>P</i><0.01; phenotypic age acceleration: corrected <i>HR</i>=1.03, <i>P</i><0.01), which was also confirmed by sensitivity analysis. ROC curves and clinical decision curves demonstrated that compared with the phenotypic age acceleration, phenotypic age had higher accuracy (the areas and the curves were 0.721 and 0.599) and higher net benefit in predicting valvular heart diseases. Moreover, compared with a single indicator, the combination of the two indicators had higher accuracy (the area under the curve was 0.725) and higher net benefit.</p><p><strong>Conclusions: </strong>Phenotypic age and phenotypic age acceleration,as markers of biological aging, are independent risk factors for valvular heart diseases. Compared with phenotypic age acceleration, phenotypic age has a greater advantage in predicting valvular heart diseases. Overall, the combination of the two indicators offers a more effective approach for predicting valvular heart diseases.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"241-249"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on collagen secretion mechanisms in scarring].","authors":"Wenkai Ye, Xinan Meng, Suhong Xu","doi":"10.3724/zdxbyxb-2024-0535","DOIUrl":"10.3724/zdxbyxb-2024-0535","url":null,"abstract":"<p><p>Scar formation is characterized by dynamic alterations in collagen secretion, which critically determine scar morphology and pathological progression. In fibroblasts, collagen secretion is initiated through the activation of cytokine- and integrin-mediated signaling pathways, which promote collagen gene transcription. The procollagen polypeptide α chains undergo extensive post-translational modifications, including hydroxylation and glycosylation, within the endoplasmic reticulum (ER), followed by folding and assembly into triple-helical procollagen. Subsequent intracellular trafficking involves the sequential transport of procollagen through the ER, Golgi apparatus, and plasma membrane, accompanied by further structural refinements prior to extracellular secretion. Once secreted, procollagen is enzymatically processed to form mature collagen fibrils, which drive scar tissue remodeling. Recent advances in elucidating regulation of collagen secretion have identified pivotal molecular targets, such as transforming growth factor-beta 1 (TGF-β1), prolyl 4-hydroxylase (P4H), heat shock protein 47 (HSP47), and transport and Golgi organization protein 1 (TANGO1), providing novel therapeutic strategies to mitigate pathological scar hyperplasia and improve regenerative outcomes. This review provides a comprehensive analysis of the molecular mechanisms governing collagen secretion during scar formation, with emphasis on signaling cascades, procollagen biosynthesis, intracellular transport dynamics, and post-translational modifications, thereby offering a framework for developing targeted anti-scar therapies.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"266-278"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Construction of a mixed valvular heart disease-related age-adjusted comorbidity index and its predictive value for patient prognosis].","authors":"Murong Xie, Haiyan Xu, Bin Zhang, Yunqing Ye, Zhe Li, Qingrong Liu, Zhenyan Zhao, Junxing Lyu, Yongjian Wu","doi":"10.3724/zdxbyxb-2024-0400","DOIUrl":"10.3724/zdxbyxb-2024-0400","url":null,"abstract":"<p><strong>Objectives: </strong>To create a mixed valvular heart disease (MVHD)-related age-adjusted comorbidity index (MVACI) model for predicting mortality risk of patients with MVHD.</p><p><strong>Methods: </strong>A total of 4080 patients with moderate or severe MVHD in the China-VHD study were included. The primary endpoint was 2-year all-cause mortality. A MVACI model prediction model was constructed based on the mortality risk factors identified by univariate and multivariate Cox regression analysis. Restricted cubic splines were used to assess the relationship between MVACI scores and 2-year all-cause mortality. The optimal threshold, determined by the maximum Youden index from receiver operator characteristic (ROC) curve analysis, was used to stratify patients. Kaplan-Meier method was used to calculate 2-year all-cause mortality and compared using the Log-rank test. Univariate and multivariate Cox proportional hazards models were employed to calculate hazard ratios (HR) and 95% confidence intervals (CI), evaluating the association between MVACI scores and mortality. Paired ROC curves were used to compare the discriminative ability of MVACI scores with the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ) or the age-adjusted Charlson comorbidity index (ACCI) in predicting 2-year clinical outcomes, while calibration curves assessed the calibration of these models. Internal validation was performed using the Bootstrap method. Subgroup analyses were conducted based on etiology, treatment strategies, and disease severity.</p><p><strong>Results: </strong>Multivariate analysis identified the following variables independently associated with 2-year all-cause mortality in patients: pulmonary hypertension, myocardiopathy, heart failure, low body weight (body mass index <18.5 kg/m²), anaemia, hypoalbuminemia, renal insufficiency, cancer, New York Heart Association (NYHA) class and age. The score was independently associated with the risk of all-cause mortality, and exhibited good discrimination (AUC=0.777, 95%<i>CI</i>: 0.755-0.799) and calibration (Brier score 0.062), with significantly better predictive performance than EuroSCORE Ⅱ or ACCI (both adjusted <i>P</i><0.01). The internal validation showed that the MVACI model's predicted probability of 2-year all-cause mortality was generally consistent with the actual probability. The AUCs for predicting all-cause mortality risk were all above 0.750, and those for predicting adverse events were all above 0.630. The prognostic value of the score remained consistent in patients regardless of their etiology, therapeutic option, and disease severity.</p><p><strong>Conclusions: </strong>The MVACI was constructed in this study based on age and comorbidities, and can be used for mortality risk prediction and risk stratification of MVHD patients. It is a simple algorithmic index and easy to use.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"230-240"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transcatheter edge-to-edge repair using MitraClip^TM G4 for severe mitral regurgitation in an advanced elderly patient with Barlow disease].","authors":"Fei Luo, Jiafeng Wang, Zhifu Guo, Yongwen Qin, Yuan Bai","doi":"10.3724/zdxbyxb-2024-0431","DOIUrl":"10.3724/zdxbyxb-2024-0431","url":null,"abstract":"<p><p>A 91-year-old male patient was admitted with a history of mitral valve prolapse diagnosed by physical examination ten years prior and recent onset of exertional chest discomfort persisting for over one month. Transthoracic echocardiography showed that the anterior leaflet of mitral valve was thickened and prolapsed with severe regurgitation, and transesophageal echocardiography further confirmed that the anterior and posterior leaflets of mitral valve were prolapsed with massive regurgitation (A1, A2, A3, P1 and P2 were all prolapsed). Thus, the diagnosis of Barlow syndrome was considered. Transcatheter edge-to-edge mitral repair was performed with two MitraClip^TM G4 XTWs. After a 10 months follow-up, the patient's cardiac function was significantly improved, and the degree of mitral regurgitation was mild.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"199-203"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}